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Titolo:
Laparoscopic partial upper pole nephrectomy in infants and children
Autore:
Horowitz, M; Shah, SM; Ferzli, G; Syad, PI; Glassberg, KI;
Indirizzi:
Suny Downstate Med Ctr, Div Paediat Urol, Brooklyn, NY 11203 USA Suny Downstate Med Ctr Brooklyn NY USA 11203 Urol, Brooklyn, NY 11203 USA Staten Isl Univ Hosp, Dept Surg, Staten Isl, NY USA Staten Isl Univ Hosp Staten Isl NY USA sp, Dept Surg, Staten Isl, NY USA
Titolo Testata:
BJU INTERNATIONAL
fascicolo: 6, volume: 87, anno: 2001,
pagine: 514 - 516
SICI:
1464-4096(200104)87:6<514:LPUPNI>2.0.ZU;2-F
Fonte:
ISI
Lingua:
ENG
Soggetto:
RENAL SURGERY; HEMINEPHROURETERECTOMY;
Keywords:
laparoscopy; partial nephrectomy; outcome;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
17
Recensione:
Indirizzi per estratti:
Indirizzo: Glassberg, KI Suny Downstate Med Ctr, Div Paediat Urol, 450 Clarkson Ave,Box 79, Brooklyn, NY 11203 USA Suny Downstate Med Ctr 450 Clarkson Ave,Box 79 Brooklyn NY USA 11203
Citazione:
M. Horowitz et al., "Laparoscopic partial upper pole nephrectomy in infants and children", BJU INT, 87(6), 2001, pp. 514-516

Abstract

Objective To retrospectively review 5 years' experience of transperitoneallaparoscopic partial nephrectomy (LPN) in infants and children. Patients and methods Between January 1995 and December 1999, 14 upper-polepartial nephrectomies (seven right and seven left) were undertaken in 13 children (mean age 3.8 years, range 0.4-14). One patient underwent bilateralupper-pole LPN. No children required a lower-pole partial nephrectomy during the study period. Evaluation included renal ultrasonography. voiding cystourethrography. renal scintigraphy and contrast-enhanced computed tomography in some cases. Three ports (10, 5 and 5 mm) were used in all except two patients, who required an additional 2 mm port for liver retraction. The diseased parenchyma was transected with electrocautery or harmonic scalpel. The distal ureter was simply transected in the absence of reflux, but tied adjacent to the bladder if reflux was present. Results The mean operative duration for LPN was 100 min, with an estimatedblood loss of < 30 mL. A liquid diet was tolerated on the first morning after surgery and age-appropriate regular diet that evening in all except onepatient. The mean hospital stay was 2.6 days. One patient bad a significant decrease in haematocrit, which was managed conservatively, not requiring transfusion. Follow-up telephone interviews with the patients' parents showed that all were satisfied with the medical and cosmetic outcome. Conclusion Transperitoneal LPN is preferable to open partial nephrectomy because: (i) The magnification provided by laparoscopy provides excellent vision for the precise dissection of the parenchyma and distal ureter, avoiding injury to the healthy tissue: (ii) There is minimal blood loss, fast recovery and less surgical scarring, and when upper-pole partial nephrectomy is required. LPN is less damaging to the lower-pole. Unlike total nephrectomy, where debate remains about open vs laparoscopic methods, the specific advantages of LPN make it clearly preferable.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 22/01/20 alle ore 09:30:19